ArticleJournal of neurology2026
Neurofilament light-chain (Nf-L) as a biomarker in seizures and status epilepticus of varying duration.
Article in Journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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6 authors.
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Abstract
backgroundNeurofilament light chain (Nf-L) is an established biomarker for neuronal damage and a prognostic parameter in many diseases of the central nervous system (CNS). In epilepsy, most studies have focused on Nf-L levels either in epileptic seizures or in status epilepticus. We sought to investigate the correlation between epileptic seizures of different duration and elevated Nf-L levels as a biomarker for neuroaxonal injury also considering methodological confounders in Nf-L measurement.
methodsIn adult patients, Nf-L was investigated in serum and/or cerebrospinal fluid (CSF) after a single epileptic seizure (51 patients), acute repetitive seizures (11 patients) or status epilepticus (20 patients) along with standard acute CSF parameters. In addition, ratios of Nf-L to age-adjusted reference intervals were calculated.
resultsIn both serum and CSF, absolute Nf-L levels were significantly increased after status epilepticus compared to patients who experienced a single seizure (serum: p < 0.0001; CSF: p = 0.0008) or acute repetitive seizures (serum: p = 0.035 CSF: p = 0.045). Similarly, age-adjusted Nf-L ratios in serum were higher after status epilepticus (median = 1.68, interquartile range = 2.81) than after a single seizure (median = 0.67, interquartile range = 0.73; p = 0.039). Though ANOVA-testing indicated significant differences in CSF Nf-L ratios between the three groups (p = 0.040), pairwise post hoc testing was not significant. A moderate significant positive correlation was observed between the duration of status epilepticus and serum Nf-L concentrations (Pearson r = 0.48, p = 0.02).
conclusionOur data indicate that single and acute repetitive seizures likely do not cause significant neuronal injury as assessed by Nf-L concentrations in serum and CSF. In contrast, status epilepticus is accompanied by a duration-dependent increase in serum Nf-L, which presumably reflects seizure-associated cellular injury and underlines the need for rapid and consistent antiseizure treatment.
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